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Boston Children's Hospital: Measuring Patient Costs SWOT Analysis / TOWS Matrix / Weighted SWOT Analysis

Case Study SWOT Analysis Solution

Case Study Description of Boston Children's Hospital: Measuring Patient Costs


The case describes two pilot projects on applying activity-based costing to measuring the cost of treating patients. It presents process maps and financial data relating to the processes used during (1) an office visit to a plastic surgeon for three different diagnoses, and (2) application and removal of three different casts in the orthopedic cast room. Students calculate and compare the costs and margins of the three procedures at the two different sites using the hospital's existing cost system and a proposed new system based on time-driven activity-based costing.

Authors :: Robert S. Kaplan, Mary L. Witkowski, Jessica A. Hohman

Topics :: Finance & Accounting

Tags :: Time management, SWOT Analysis, SWOT Matrix, TOWS, Weighted SWOT Analysis

Swot Analysis of "Boston Children's Hospital: Measuring Patient Costs" written by Robert S. Kaplan, Mary L. Witkowski, Jessica A. Hohman includes – strengths weakness that are internal strategic factors of the organization, and opportunities and threats that Costing Measuring facing as an external strategic factors. Some of the topics covered in Boston Children's Hospital: Measuring Patient Costs case study are - Strategic Management Strategies, Time management and Finance & Accounting.


Some of the macro environment factors that can be used to understand the Boston Children's Hospital: Measuring Patient Costs casestudy better are - – increasing inequality as vast percentage of new income is going to the top 1%, customer relationship management is fast transforming because of increasing concerns over data privacy, technology disruption, there is increasing trade war between United States & China, there is backlash against globalization, banking and financial system is disrupted by Bitcoin and other crypto currencies, supply chains are disrupted by pandemic , talent flight as more people leaving formal jobs, challanges to central banks by blockchain based private currencies, etc



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Introduction to SWOT Analysis of Boston Children's Hospital: Measuring Patient Costs


SWOT stands for an organization’s Strengths, Weaknesses, Opportunities and Threats . At Oak Spring University , we believe that protagonist in Boston Children's Hospital: Measuring Patient Costs case study can use SWOT analysis as a strategic management tool to assess the current internal strengths and weaknesses of the Costing Measuring, and to figure out the opportunities and threats in the macro environment – technological, environmental, political, economic, social, demographic, etc in which Costing Measuring operates in.

According to Harvard Business Review, 75% of the managers use SWOT analysis for various purposes such as – evaluating current scenario, strategic planning, new venture feasibility, personal growth goals, new market entry, Go To market strategies, portfolio management and strategic trade-off assessment, organizational restructuring, etc.




SWOT Objectives / Importance of SWOT Analysis and SWOT Matrix


SWOT analysis of Boston Children's Hospital: Measuring Patient Costs can be done for the following purposes –
1. Strategic planning using facts provided in Boston Children's Hospital: Measuring Patient Costs case study
2. Improving business portfolio management of Costing Measuring
3. Assessing feasibility of the new initiative in Finance & Accounting field.
4. Making a Finance & Accounting topic specific business decision
5. Set goals for the organization
6. Organizational restructuring of Costing Measuring




Strengths Boston Children's Hospital: Measuring Patient Costs | Internal Strategic Factors
What are Strengths in SWOT Analysis / TOWS Matrix / Weighted SWOT Analysis

The strengths of Costing Measuring in Boston Children's Hospital: Measuring Patient Costs Harvard Business Review case study are -

Organizational Resilience of Costing Measuring

– The covid-19 pandemic has put organizational resilience at the centre of everthing that Costing Measuring does. Organizational resilience comprises - Financial Resilience, Operational Resilience, Technological Resilience, Organizational Resilience, Business Model Resilience, and Reputation Resilience.

Strong track record of project management

– Costing Measuring is known for sticking to its project targets. This enables the firm to manage – time, project costs, and have sustainable margins on the projects.

Successful track record of launching new products

– Costing Measuring has launched numerous new products in last few years, keeping in mind evolving customer preferences and competitive pressures. Costing Measuring has effective processes in place that helps in exploring new product needs, doing quick pilot testing, and then launching the products quickly using its extensive distribution network.

High switching costs

– The high switching costs that Costing Measuring has built up over years in its products and services combo offer has resulted in high retention of customers, lower marketing costs, and greater ability of the firm to focus on its customers.

Low bargaining power of suppliers

– Suppliers of Costing Measuring in the sector have low bargaining power. Boston Children's Hospital: Measuring Patient Costs has further diversified its suppliers portfolio by building a robust supply chain across various countries. This helps Costing Measuring to manage not only supply disruptions but also source products at highly competitive prices.

Superior customer experience

– The customer experience strategy of Costing Measuring in the segment is based on four key concepts – personalization, simplification of complex needs, prompt response, and continuous engagement.

High brand equity

– Costing Measuring has strong brand awareness and brand recognition among both - the exiting customers and potential new customers. Strong brand equity has enabled Costing Measuring to keep acquiring new customers and building profitable relationship with both the new and loyal customers.

Diverse revenue streams

– Costing Measuring is present in almost all the verticals within the industry. This has provided firm in Boston Children's Hospital: Measuring Patient Costs case study a diverse revenue stream that has helped it to survive disruptions such as global pandemic in Covid-19, financial disruption of 2008, and supply chain disruption of 2021.

Cross disciplinary teams

– Horizontal connected teams at the Costing Measuring are driving operational speed, building greater agility, and keeping the organization nimble to compete with new competitors. It helps are organization to ideate new ideas, and execute them swiftly in the marketplace.

Learning organization

- Costing Measuring is a learning organization. It has inculcated three key characters of learning organization in its processes and operations – exploration, creativity, and expansiveness. The work place at Costing Measuring is open place that encourages instructiveness, ideation, open minded discussions, and creativity. Employees and leaders in Boston Children's Hospital: Measuring Patient Costs Harvard Business Review case study emphasize – knowledge, initiative, and innovation.

Sustainable margins compare to other players in Finance & Accounting industry

– Boston Children's Hospital: Measuring Patient Costs firm has clearly differentiated products in the market place. This has enabled Costing Measuring to fetch slight price premium compare to the competitors in the Finance & Accounting industry. The sustainable margins have also helped Costing Measuring to invest into research and development (R&D) and innovation.

Analytics focus

– Costing Measuring is putting a lot of focus on utilizing the power of analytics in business decision making. This has put it among the leading players in the industry. The technology infrastructure suggested by Robert S. Kaplan, Mary L. Witkowski, Jessica A. Hohman can also help it to harness the power of analytics for – marketing optimization, demand forecasting, customer relationship management, inventory management, information sharing across the value chain etc.






Weaknesses Boston Children's Hospital: Measuring Patient Costs | Internal Strategic Factors
What are Weaknesses in SWOT Analysis / TOWS Matrix / Weighted SWOT Analysis

The weaknesses of Boston Children's Hospital: Measuring Patient Costs are -

Low market penetration in new markets

– Outside its home market of Costing Measuring, firm in the HBR case study Boston Children's Hospital: Measuring Patient Costs needs to spend more promotional, marketing, and advertising efforts to penetrate international markets.

High cash cycle compare to competitors

Costing Measuring has a high cash cycle compare to other players in the industry. It needs to shorten the cash cycle by 12% to be more competitive in the marketplace, reduce inventory costs, and be more profitable.

No frontier risks strategy

– After analyzing the HBR case study Boston Children's Hospital: Measuring Patient Costs, it seems that company is thinking about the frontier risks that can impact Finance & Accounting strategy. But it has very little resources allocation to manage the risks emerging from events such as natural disasters, climate change, melting of permafrost, tacking the rise of artificial intelligence, opportunities and threats emerging from commercialization of space etc.

Need for greater diversity

– Costing Measuring has taken concrete steps on diversity, equity, and inclusion. But the efforts so far has resulted in limited success. It needs to expand the recruitment and selection process to hire more people from the minorities and underprivileged background.

Slow to strategic competitive environment developments

– As Boston Children's Hospital: Measuring Patient Costs HBR case study mentions - Costing Measuring takes time to assess the upcoming competitions. This has led to missing out on atleast 2-3 big opportunities in the industry in last five years.

Workers concerns about automation

– As automation is fast increasing in the segment, Costing Measuring needs to come up with a strategy to reduce the workers concern regarding automation. Without a clear strategy, it could lead to disruption and uncertainty within the organization.

Slow to harness new channels of communication

– Even though competitors are using new communication channels such as Instagram, Tiktok, and Snap, Costing Measuring is slow explore the new channels of communication. These new channels of communication mentioned in marketing section of case study Boston Children's Hospital: Measuring Patient Costs can help to provide better information regarding products and services. It can also build an online community to further reach out to potential customers.

Aligning sales with marketing

– It come across in the case study Boston Children's Hospital: Measuring Patient Costs that the firm needs to have more collaboration between its sales team and marketing team. Sales professionals in the industry have deep experience in developing customer relationships. Marketing department in the case Boston Children's Hospital: Measuring Patient Costs can leverage the sales team experience to cultivate customer relationships as Costing Measuring is planning to shift buying processes online.

Increasing silos among functional specialists

– The organizational structure of Costing Measuring is dominated by functional specialists. It is not different from other players in the Finance & Accounting segment. Costing Measuring needs to de-silo the office environment to harness the true potential of its workforce. Secondly the de-silo will also help Costing Measuring to focus more on services rather than just following the product oriented approach.

Capital Spending Reduction

– Even during the low interest decade, Costing Measuring has not been able to do capital spending to the tune of the competition. This has resulted into fewer innovations and company facing stiff competition from both existing competitors and new entrants who are disrupting the industry using digital technology.

Interest costs

– Compare to the competition, Costing Measuring has borrowed money from the capital market at higher rates. It needs to restructure the interest payment and costs so that it can compete better and improve profitability.




Opportunities Boston Children's Hospital: Measuring Patient Costs | External Strategic Factors
What are Opportunities in the SWOT Analysis / TOWS Matrix / Weighted SWOT Analysis


The opportunities highlighted in the Harvard Business Review case study Boston Children's Hospital: Measuring Patient Costs are -

Changes in consumer behavior post Covid-19

– Consumer behavior has changed in the Finance & Accounting industry because of Covid-19 restrictions. Some of this behavior will stay once things get back to normal. Costing Measuring can take advantage of these changes in consumer behavior to build a far more efficient business model. For example consumer regular ordering of products can reduce both last mile delivery costs and market penetration costs. Costing Measuring can further use this consumer data to build better customer loyalty, provide better products and service collection, and improve the value proposition in inflationary times.

Reforming the budgeting process

- By establishing new metrics that will be used to evaluate both existing and potential projects Costing Measuring can not only reduce the costs of the project but also help it in integrating the projects with other processes within the organization.

Remote work and new talent hiring opportunities

– The widespread usage of remote working technologies during Covid-19 has opened opportunities for Costing Measuring to expand its talent hiring zone. According to McKinsey Global Institute, 20% of the high end workforce in fields such as finance, information technology, can continously work from remote local post Covid-19. This presents a really great opportunity for Costing Measuring to hire the very best people irrespective of their geographical location.

Buying journey improvements

– Costing Measuring can improve the customer journey of consumers in the industry by using analytics and artificial intelligence. Boston Children's Hospital: Measuring Patient Costs suggest that firm can provide automated chats to help consumers solve their own problems, provide online suggestions to get maximum out of the products and services, and help consumers to build a community where they can interact with each other to develop new features and uses.

Increase in government spending

– As the United States and other governments are increasing social spending and infrastructure spending to build economies post Covid-19, Costing Measuring can use these opportunities to build new business models that can help the communities that Costing Measuring operates in. Secondly it can use opportunities from government spending in Finance & Accounting sector.

Manufacturing automation

– Costing Measuring can use the latest technology developments to improve its manufacturing and designing process in Finance & Accounting segment. It can use CAD and 3D printing to build a quick prototype and pilot testing products. It can leverage automation using machine learning and artificial intelligence to do faster production at lowers costs, and it can leverage the growth in satellite and tracking technologies to improve inventory management, transportation, and shipping.

Reconfiguring business model

– The expansion of digital payment system, the bringing down of international transactions costs using Bitcoin and other blockchain based currencies, etc can help Costing Measuring to reconfigure its entire business model. For example it can used blockchain based technologies to reduce piracy of its products in the big markets such as China. Secondly it can use the popularity of e-commerce in various developing markets to build a Direct to Customer business model rather than the current Channel Heavy distribution network.

Use of Bitcoin and other crypto currencies for transactions

– The popularity of Bitcoin and other crypto currencies as asset class and medium of transaction has opened new opportunities for Costing Measuring in the consumer business. Now Costing Measuring can target international markets with far fewer capital restrictions requirements than the existing system.

Developing new processes and practices

– Costing Measuring can develop new processes and procedures in Finance & Accounting industry using technology such as automation using artificial intelligence, real time transportation and products tracking, 3D modeling for concept development and new products pilot testing etc.

Identify volunteer opportunities

– Covid-19 has impacted working population in two ways – it has led to people soul searching about their professional choices, resulting in mass resignation. Secondly it has encouraged people to do things that they are passionate about. This has opened opportunities for businesses to build volunteer oriented socially driven projects. Costing Measuring can explore opportunities that can attract volunteers and are consistent with its mission and vision.

Building a culture of innovation

– managers at Costing Measuring can make experimentation a productive activity and build a culture of innovation using approaches such as – mining transaction data, A/B testing of websites and selling platforms, engaging potential customers over various needs, and building on small ideas in the Finance & Accounting segment.

Better consumer reach

– The expansion of the 5G network will help Costing Measuring to increase its market reach. Costing Measuring will be able to reach out to new customers. Secondly 5G will also provide technology framework to build new tools and products that can help more immersive consumer experience and faster consumer journey.

Finding new ways to collaborate

– Covid-19 has not only transformed business models of companies in Finance & Accounting industry, but it has also influenced the consumer preferences. Costing Measuring can tie-up with other value chain partners to explore new opportunities regarding meeting customer demands and building a rewarding and engaging relationship.




Threats Boston Children's Hospital: Measuring Patient Costs External Strategic Factors
What are Threats in the SWOT Analysis / TOWS Matrix / Weighted SWOT Analysis


The threats mentioned in the HBR case study Boston Children's Hospital: Measuring Patient Costs are -

Environmental challenges

– Costing Measuring needs to have a robust strategy against the disruptions arising from climate change and energy requirements. EU has identified it as key priority area and spending 30% of its 880 billion Euros European post Covid-19 recovery funds on green technology. Costing Measuring can take advantage of this fund but it will also bring new competitors in the Finance & Accounting industry.

Stagnating economy with rate increase

– Costing Measuring can face lack of demand in the market place because of Fed actions to reduce inflation. This can lead to sluggish growth in the economy, lower demands, lower investments, higher borrowing costs, and consolidation in the field.

High dependence on third party suppliers

– Costing Measuring high dependence on third party suppliers can disrupt its processes and delivery mechanism. For example -the current troubles of car makers because of chip shortage is because the chip companies started producing chips for electronic companies rather than car manufacturers.

Trade war between China and United States

– The trade war between two of the biggest economies can hugely impact the opportunities for Costing Measuring in the Finance & Accounting industry. The Finance & Accounting industry is already at various protected from local competition in China, with the rise of trade war the protection levels may go up. This presents a clear threat of current business model in Chinese market.

Aging population

– As the populations of most advanced economies are aging, it will lead to high social security costs, higher savings among population, and lower demand for goods and services in the economy. The household savings in US, France, UK, Germany, and Japan are growing faster than predicted because of uncertainty caused by pandemic.

New competition

– After the dotcom bust of 2001, financial crisis of 2008-09, the business formation in US economy had declined. But in 2020 alone, there are more than 1.5 million new business applications in United States. This can lead to greater competition for Costing Measuring in the Finance & Accounting sector and impact the bottomline of the organization.

Barriers of entry lowering

– As technology is more democratized, the barriers to entry in the industry are lowering. It can presents Costing Measuring with greater competitive threats in the near to medium future. Secondly it will also put downward pressure on pricing throughout the sector.

High level of anxiety and lack of motivation

– the Great Resignation in United States is the sign of broader dissatisfaction among the workforce in United States. Costing Measuring needs to understand the core reasons impacting the Finance & Accounting industry. This will help it in building a better workplace.

Instability in the European markets

– European Union markets are facing three big challenges post Covid – expanded balance sheets, Brexit related business disruption, and aggressive Russia looking to distract the existing security mechanism. Costing Measuring will face different problems in different parts of Europe. For example it will face inflationary pressures in UK, France, and Germany, balance sheet expansion and demand challenges in Southern European countries, and geopolitical instability in the Eastern Europe.

Capital market disruption

– During the Covid-19, Dow Jones has touched record high. The valuations of a number of companies are way beyond their existing business model potential. This can lead to capital market correction which can put a number of suppliers, collaborators, value chain partners in great financial difficulty. It will directly impact the business of Costing Measuring.

Consumer confidence and its impact on Costing Measuring demand

– There is a high probability of declining consumer confidence, given – high inflammation rate, rise of gig economy, lower job stability, increasing cost of living, higher interest rates, and aging demography. All the factors contribute to people saving higher rate of their income, resulting in lower consumer demand in the industry and other sectors.

Technology acceleration in Forth Industrial Revolution

– Costing Measuring has witnessed rapid integration of technology during Covid-19 in the Finance & Accounting industry. As one of the leading players in the industry, Costing Measuring needs to keep up with the evolution of technology in the Finance & Accounting sector. According to Mckinsey study top managers believe that the adoption of technology in operations, communications is 20-25 times faster than what they planned in the beginning of 2019.

Technology disruption because of hacks, piracy etc

– The colonial pipeline illustrated, how vulnerable modern organization are to international hackers, miscreants, and disruptors. The cyber security interruption, data leaks, etc can seriously jeopardize the future growth of the organization.




Weighted SWOT Analysis of Boston Children's Hospital: Measuring Patient Costs Template, Example


Not all factors mentioned under the Strengths, Weakness, Opportunities, and Threats quadrants in the SWOT Analysis are equal. Managers in the HBR case study Boston Children's Hospital: Measuring Patient Costs needs to zero down on the relative importance of each factor mentioned in the Strengths, Weakness, Opportunities, and Threats quadrants. We can provide the relative importance to each factor by assigning relative weights. Weighted SWOT analysis process is a three stage process –

First stage for doing weighted SWOT analysis of the case study Boston Children's Hospital: Measuring Patient Costs is to rank the strengths and weaknesses of the organization. This will help you to assess the most important strengths and weaknesses of the firm and which one of the strengths and weaknesses mentioned in the initial lists are marginal and can be left out.

Second stage for conducting weighted SWOT analysis of the Harvard case study Boston Children's Hospital: Measuring Patient Costs is to give probabilities to the external strategic factors thus better understanding the opportunities and threats arising out of macro environment changes and developments.

Third stage of constructing weighted SWOT analysis of Boston Children's Hospital: Measuring Patient Costs is to provide strategic recommendations includes – joining likelihood of external strategic factors such as opportunities and threats to the internal strategic factors – strengths and weaknesses. You should start with external factors as they will provide the direction of the overall industry. Secondly by joining probabilities with internal strategic factors can help the company not only strategic fit but also the most probably strategic trade-off that Costing Measuring needs to make to build a sustainable competitive advantage.



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